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Once tissue has died, the gallbladder is at greatly increased risk of rupture (perforation), which can cause sharp pain. Rupture can also occur in cases of chronic cholecystitis. [13] Rupture is a rare but serious complication that leads to abscess formation or peritonitis. [14] Massive rupture of the gallbladder has a mortality rate of 30%. [13]
About 10% of cases have a more serious cause including gallbladder (gallstones or biliary dyskinesia) or pancreas problems (4%), diverticulitis (3%), appendicitis (2%) and cancer (1%). [2] More common in those who are older, ischemic colitis , [ 5 ] mesenteric ischemia , and abdominal aortic aneurysms are other serious causes.
Appendicitis symptoms fall into two categories, typical and atypical. [ 37 ] Typical appendicitis is characterized by a migratory right iliac fossa pain associated with nausea, and anorexia, which can occur with or without vomiting and localized muscle stiffness/ generalized guarding . [ 37 ]
Appendicitis is one of those conditions that you wouldn't wish on your worst enemy. The pains are so excruciating you feel like you're going to die, and if left untreated and your appendix ...
Murphy's sign has a high sensitivity and negative predictive value, although the specificity is not high. [2] However, in the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.
Rovsing's sign, named after the Danish surgeon Niels Thorkild Rovsing (1862–1927), [1] is a sign of appendicitis.If palpation of the left lower quadrant of a person's abdomen increases the pain felt in the right lower quadrant, the patient is said to have a positive Rovsing's sign and may have appendicitis.
Biliary colic, also known as symptomatic cholelithiasis, a gallbladder attack or gallstone attack, is when a colic (sudden pain) occurs due to a gallstone temporarily blocking the cystic duct. [1] Typically, the pain is in the right upper part of the abdomen , and can be severe. [ 2 ]
In patients nursed in a sitting position, fluid from the stomach, duodenum, or gallbladder may run down the paracolic gutter to collect in the right iliac fossa or pelvis. This may mimic acute appendicitis or form a pelvic abscess. The left paracolic gutter is larger than the right, which together with the partial barrier provided by the ...